Frank Tokic, CPA
Principal

Frank has over 30 years of healthcare experience with 25 years of healthcare consulting experience in assisting healthcare providers with reimbursement and regulatory issues. He has a wide range of experience in the areas of hospital finance, budgeting, compliance, hospital pricing and Medicare/Medicaid reimbursement.

AREAS OF SPECIALIZATION

  • Hospital strategic pricing reviews
  • Pretium® pricing software product developer
  • Hospital revenue reviews and claim analytics
  • Medicare Patient Charging and Billing
  • Medicare/Medicaid reimbursement
  • Claim analytic and compliance reviews

EDUCATION

Bachelor of Science, Accounting
University of Kansas, Lawrence, KS

EXPERIENCE

Coordinated the development of Pretium® online pricing software for establishing prices for hospital services.

Developed pricing software to analyze the financial impact of implement pricing methodologies for hospital services.

Software development for DRG transfer review services.

Assists hospitals in the development of pricing transparency policies.

Developed software tools to identify claim compliance issues and analyze billing metrics.

Assists clients in the preparation of Medicare and Medicaid cost reports.

Medicare bad debt reviews.

Prepares and submits client position papers and other related documentation to the Provider Reimbursement Review Board for Medicare cost report appeals. 

Performs studies to determine the financial impact of whether patient services should be delivered as provider based or free standing.

Preparation of Sole Community Hospital and Medicare Dependent Hospital volume adjustment requests.

Preparation of psychiatric and rehabilitation TEFRA and SNF exception requests.

Senior Manager for a national consulting firm, responsible for planning and APC reviews. Responsible for the coordination of Medicare reimbursement projects.

Manager in the healthcare consulting group for a “Big Six” accounting firm,  responsible for Medicare and Medicaid cost report reviews and psychiatric and rehabilitation exception requests.

Medicare senior auditor for a regional Medicare intermediary performing Medicare audits for hospitals, skilled nursing facilities and home health agencies. Responsibilities included the supervision of graduate medical education program base year audits. Coordinated and supervised internal training program for hospital staff auditors.